Raquel Hicks
Broad Brook,CT
Summary
Results-driven professional seeking position as Manager, Revenue Cycle Management. Focused on performance and flexible with specific needs of different assignments. Collaborates professionally with individuals from broad array of backgrounds and cultures.
Overview
27
27
years of professional experience
Work History
Operations Supervisor
Parallon/HCA
01.2018 - Current
- Screen, interview, and coordinate hiring offers with HR/recruiting
- Supervising staff of 10-15 employees
- Weekly Payroll and Audits, PTO approval
- Annual team reviews
- Examine claims forms and other records for Insurance submission
- Negotiate settlements to obtain highest possible reimbursement for clients
- Review weekly AR to minimize aging and manage account handling
- Motivated and trained employees to maximize team productivity.
- Enforced regulatory and company policy compliance to improve workplace and employee safety and readiness.
- Enhanced operational performance and reduced labor expenses by developing and optimizing standard practices.
- Encouraged and promoted ideas aligned to business needs and benefits.
- Lead associate focus groups and meetings to obtain suggestions, address concerns or issues and foster positive relations among team members and management.
- Conducted root cause analysis in deficient areas to identify and resolve issues.
- Trained new employees on proper protocols and customer service standards.
- Trained and guided team members to maintain high productivity and performance metrics.
- Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
- Directed product flow and informed management of delays and challenges, as well as suggested resolutions.
Team Lead
Parallon/HCA
01.2015 - 01.2018
- Coached team members in techniques necessary to complete job tasks.
- Trained new team members by relaying information on company procedures and safety requirements.
- Worked multiple clients to provide optimal coverage and meet production goals.
- Evaluated employee skills and knowledge regularly, training and mentoring individuals with lagging skills.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.
- Took on additional job duties during unexpected backlog, resulting in meeting project target date.
- Reviewed denials for possible appeal.
- Examine claim forms and other records for insurance submission.
- Review payments to ensure claims processed correctly.
- Participated in cross-functional team-building activities.
- Instructed junior team members on protocols and procedures of each station to maximize contributions.
Claims Specialist
Parallon/HCA
01.2012 - 01.2015
- Conducted full claim investigations and reported updates and legal actions.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Escalated files as needed
- Addressed average of 300 plus accounts each week.
- Generated, posted and attached information to claim files.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient records and health statuses.
- Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
- Checked documentation for accuracy and validity on updated systems.
- Resubmitted claims after editing or denial to achieve financial target.
Associate Claim Rep
Parallon/HCA
01.2010 - 01.2012
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Generated, posted and attached information to claim files.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Administrative
Lauren Staffing LLC
Glastonbury, CT
01.2007 - 03.2010
- American Wood Moulding
- Answering phones, filing, and generating bills
- Plan, administer and control budgets for contracts, equipment and supplies
- Prepare and review operational reports and schedules to ensure accuracy and efficiency
- CT Children's Medical Center
- Filing patient reports in charts, pulling and coping radiology films for doctors and parents
- Pulling and organizing patient charts, data entry and assisting with scheduling appointments
- Preparing Patient bills and attaching insurance in Nextgen system.
Insurance Agent
Prime America Financial Services
01.2003 - 01.2007
- Sell various types of insurance policies to individuals on behalf of insurance companies
- Interview prospective clients to obtain data about their financial resources and needs, the physical condition of the person or property to be insured, and to discuss any existing coverage
- Call on policyholders to deliver and explain policy, to analyze insurance program and suggest additions or changes, or to change beneficiaries
- Seek out new clients and develop clientele by networking to find new customers and generate lists of prospective clients
- Ensure that policy requirements are fulfilled, including any necessary medical examinations and the completion of appropriate forms
- Explain features, advantages and disadvantages of various policies to promote sale of insurance plans
- Calculate premiums and establish payment method.
CNA, New England Home Care
West Hartford, CT
01.1999 - 01.2003
- Complete physical checks and monitor patients to detect unusual or harmful behavior and report observations to professional staff
- Record and maintain patient information, such as vital signs, eating habits, behavior, progress notes, treatments, or discharge plans
- Maintain patients' restrictions to assigned areas
- Provide patients with assistance in bathing, dressing, or grooming, demonstrating these skills as necessary
- Organize, supervise, or encourage patient participation in social, educational, or recreational activities.
Proof Operator 1/Operations Clerk
Fleet Services
Hartford, CT
01.1996 - 01.1999
- Processing on Banc Tec and NCR machines
- Supervision of unit and doing nightly reports
- Training of new and existing employees during bank merger
- Supervision of employee productivity, monitoring transactions for accuracy and deadline's.
Education
No Degree - Medical Billing And Coding
Argosy University
CNA -
Educational Training of Wethersfield
03.1999
Skills
- Microsoft office, PowerPoint, FACS, Artiva, Assurance/change heath Care system, Epic, Meditech
- Focus and Follow-Through
- Performance Monitoring and Evaluation
- Accuracy and Efficiency in Documentation
- Operational Efficiency and Safety
- Records Organization and Management
- Hiring and Onboarding
- Problem Anticipation and Resolution
- Process Development and Streamlining
Timeline
Operations Supervisor
Parallon/HCA
01.2018 - Current
Team Lead
Parallon/HCA
01.2015 - 01.2018
Claims Specialist
Parallon/HCA
01.2012 - 01.2015
Associate Claim Rep
Parallon/HCA
01.2010 - 01.2012
Administrative
Lauren Staffing LLC
01.2007 - 03.2010
Insurance Agent
Prime America Financial Services
01.2003 - 01.2007
CNA, New England Home Care
01.1999 - 01.2003
Proof Operator 1/Operations Clerk
Fleet Services
01.1996 - 01.1999
No Degree - Medical Billing And Coding
Argosy University
CNA -
Educational Training of Wethersfield
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